MRS. Christine Dianne Long

NPI #1356684005 in Ceres, California

Provider Information

NPI Number: 1356684005
Entity Type: Individual
Name: MRS. Christine Dianne Long
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Technician
Enumeration Date: Apr 1, 2013
Last Updated: Aug 16, 2013

Practice Location

Address: 1904 RICHLAND AVE
City: Ceres
State: California
ZIP Code: 95307-4562
Phone: (209) 541-2121

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X
Substance Abuse Rehabilitation Facility	324500000X
Technician	374700000X	Primary

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